Ambulatory care visits and quality of care: does the volume-control policy matter?

Area of Science:

• Health economics
• Healthcare policy
• Patient outcomes

Background:

• The Bureau of National Health Insurance (BNHI) in Taiwan implemented a hospital volume control policy for ambulatory care.
• Understanding the impact of such policies on healthcare utilization and patient experience is crucial for effective healthcare management.

Purpose of the Study:

• To investigate the effects of the hospital volume control policy on visit frequency, medical expenses, and patient satisfaction.
• To analyze the financial burden shift from the Bureau of National Health Insurance to patients.

Main Methods:

• Utilized claims data from the BNHI.
• Collected primary data from 940 patients via questionnaires during out-patient clinic visits.
• Analyzed changes in physician fees, number of visits, co-payments, total medical expenses, and patient satisfaction.

Main Results:

• The volume control policy led to decreased physician fees.
• There was an increase in the number of patient visits and co-payments.
• Total medical expenses remained unchanged, indicating a shift in expenditure from the BNHI to patients.
• Patient satisfaction did not improve; while wait times were acceptable, dissatisfaction arose from visit quota limitations.

Conclusions:

• The ambulatory care volume control policy redistributed healthcare costs without enhancing patient satisfaction.
• Limitations on visit quotas negatively impacted patient perception despite efforts to manage healthcare resources.